Acupuncture Appointment Contact Form

(This contact from for the first session only)

* Required Field

Acupuncture Appointment Contact Form

Urgency of Acupuncture Treatment Need *

0

1

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4

5

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9

10

0=Not Urgent at all, 10=Extremely Urgent

Client Legal Name *

Client Gender * Male Female Other

Client Birthday *

Client Age *

Is Client Related to Our Existing Client? *

NO

YES ( Existing Client Name :

Contact Name *

Relationship to Client *

Contact Phone Number *

Contact Email Address *

Is it OK to leave you a message at your Phone or Email ? *

YES for Phone and Email YES for Phone Message Only YES for Email Only

Preferred Contact Method *

Phone and Email Phone only Email only

What is your primary issues * Pain Management Digestive Issues Depression / Anxiety Sleep Issues Other Psychological Issues Other

Preferred Payment Methed * Don't have Insurance, Self-pay Have Insurance but Self-pay Insurance No preference

What's your Insurance Name? *

(Please check if we can accept your insurance https://www.tenderrockcounseling.org/bellevue/medical-insurance-for-acupuncture/)

What's your Insurance ID Number? *

What's your Insurance Group Number? *

What's the Insurance Subscriber Name? *

What's the Insurance Subscriber Birthday? *

What's The Client's Relationship To The Subscriber? *

Preferred Schedule Day (select one or more) *

Wednesday

Friday

Preferred Schedule Time (select one or more) *

Anytime

10:00-11:00

11:00-12:00

12:00-13:00

13:00-14:00

14:00-15:00

15:00-16:00

16:00-17:00

17:00-18:00

18:00-19:00

Preferred Schedule Start From * This Week Next Week 2 Weeks Later 3 Weeks Later

How did you find us? * Referral by Insurance Co. Google Search Yahoo Search Bing Search Other Search Engine Facebook Yelp / Google+ / Blog / Other internet source Referral by other provider Family Member / Friend Tender Rock Counceling Team Referral I am the returning client Other

Additional Information (If need)

Tender Rock Counseling / Acupuncture / Neurofeedback
– Non Profit Organization | Counselors with Christian Faith
Bellevue / Redmond / Eastside, Washington

– Neurofeedback Therapists, Neurofeedback Training Program and Neurofeedback Counseling –
To get help for Neurofeedback Training / Treatments in Bellevue, Factoria, Eastside, Redmond, WA, near Renton, Issaquah, Medina, Mercer Island, Sammamish, Woodinville, Newcastle, Kirkland and Bellevue, WA. Tender Rock NeurOptimal / Neurofeedback Training Center.
– Counseling, NeurOptimal – Neurofeedback & Acupuncture Low Fee Clinic Services: Low Cost Counseling / Low Fee Psychotherapy –
Tender Rock Counseling, NeurOptimal – Neurofeedback Training Center & Acupuncture Clinic provides Low-Fee Psychotherapy / Low-Cost Counseling Services for those with extremely limited incomes. To apply for Low Income Clinic services,  please check out our website for Low Fee Clinic information, or contact Tender Rock Counseling & Acupuncture & Neurofeedbcak, Non Profit Organization | Counselors with Christian Faith at Bellevue, Factoria, Eastside, Redmond WA

– Mental Health Counselor Jobs, Employment in Bellevue, Factoria, Eastside, Redmond Washington –
Mental Health Counseling Jobs in Bellevue / Factoria / Eastside / Redmond Washington – Counselor Jobs, Employment in Washington | Tender Rock Counseling / Acupuncture / Neurofeedback Center( Non Profit Organization | Counselors with Christian Faith ). Jobs opening for Counselors, Mental Health Counseling Career Opportunities. Need Mental Health Counseling Career Opportunities? Looking for a part-time / full-time therapist to work in a Christian counseling center. Are you a professional Christian Counselor / Therapist? Welcome to join us – Tender Rock Counseling, NeurOptimal – Neurofeedback & Acupuncture ( Non Profit Organization | Christian Counselors ).

– Eating Disorder counseling and Disordered Eating in Bellevue, Factoria, Eastside, Redmond WA –
Have Eating Disorder counseling and Disordered Eating Counseling needs? Tender Rock Counseling Center provides Eating Disorder counseling and Disordered Eating Counseling Services in Bellevue, WA. Find professional and caring therapy for Eating Disorder counseling and Disordered Eating Counseling in Bellevue. Advice from a licensed Eating Disorder counseling and Disordered Eating Counseling in Bellevue (Factoria)- contact with Tender Rock Counseling Center, please contact Tender Rock Counseling, NeurOptimal – Neurofeedback Training Center & Acupuncture Clinic, in Bellevue / Factoria / Eastside / Redmond WA. ( Non Profit Organization | Counselors with Christian Faith)
-About Tender Rock Counseling, NeurOptimal – Neurofeedback Training Center, Acupuncture Clinic –
Tender Rock Counseling, NeurOptimal – Neurofeedback, Acupuncture Center ( Non Profit Organization | Counselors with Christian Faith ) in Bellevue / Factoria / Eastside / Redmond WA, providers different types of Mental Health Counseling, Neurofeedback Training and Acupuncture Treatment by Christian Therapists: Marriage Counseling, Family Counseling, Interracial Marriage Counseling, Couples Counseling , Grief & Life Transition Counseling, Parenting Counseling, Christian Counseling, Relationship Counseling, Depression Counseling, Post-traumatic Stress Disorder (PTSD) Counseling, Abuse Counseling, Anxiety Counseling, Child (Children), Teens/ Adolescents, Adults, Elders Counseling, Trauma ( Childhood Trauma ) Counseling, Adoption Counseling, Attachment Counseling, Autism Counseling, Stress Management Counseling, Acupuncture Treatment, Neurofeedback Training Treatment, Divorce Counseling, Sexual Abuse Counseling, Grief & Loss Counseling, Anxiety and Depression Counseling, Chinese American Counseling, Eating Disorders Counseling, Disordered Eating Counseling, Bulimia/ Anorexia Counseling, Self-Harming Counseling, ADHD Counseling, Obsessive Compulsive Disorder (OCD) Counseling, Suicide Counseling, Acupuncture (Pain Management , Naprapathy, Chinese Massage (Tui Na Massage), Herbal consultation), NeurOptimal – Neurofeedback Training and Mental Health Counseling in Bellevue / Factoria / Eastside / Redmond WA.( Tender Rock Counseling / Acupuncture / Neurofeedback, Non Profit Organization | Counselors with Christian Faith.)
Tender Rock Counseling, NeurOptimal – Neurofeedback, Acupuncture Center ( Non Profit Organization | Counselors with Christian Faith ) in Redmond / Bellevue / Factoria / Eastside, WA is Christ-centered counseling center, although all the therapists associated with Tender Rock Counseling, NeurOptimal – Neurofeedback, Acupuncture Center share similar Christian values.
– Location –
Tender Rock Counseling, NeurOptimal – Neurofeedback Training Center & Acupuncture Clinic provide counseling and therapy services for individuals, couples and families in and around Redmond, Renton, Issaquah, Medina, Mercer Island, Sammamish, Woodinville, Newcastle, Kirkland and Bellevue, WA.
Tender Rock Counseling / Acupuncture / Neurofeedback is conveniently located in Bellevue, WA across from the Factoria Mall near the intersection of I-90 and I-405. It’s convenient for you to come here from King County: Redmond, Renton, Issaquah, Medina, Mercer Island, Sammamish, Woodinville, Newcastle, Kirkland and Bellevue, WA.
– Acupuncture柔石针灸诊所提供针灸治疗(中文预约服务) –
柔石针灸诊所, 针灸师Yee能说流利中文(普通话), 广东话及英文. 她具有专业针灸证照。柔石针灸诊所专门治疗各种疼痛, 睡眠问题, 忧郁, 躁郁, 压力大…等等, 各种身体及心理的不适。除了以针灸提供有效治疗, 额外提供中国式按摩(不另收费), 更能舒缓你心理的不适及身体疼痛!我们接受多家医疗保险, 亦接受自费。可使用现金以及信用卡付费。柔石针灸诊所位于Bellevue, 在Factoria Mall正对面, 靠近I-90及 I-405出入口, 交通非常方便. 柔石针灸诊所提供各种专业针灸治疗服务, 特别专治 :一般健康保健, 各种疼痛, 睡眠問題, 心血管相关疾病, 呼吸道相关疾病, 消化系统相关疾病, 妇科相关问题疾病, 内分泌失调及相关疾病, 神经系统疾病 / 心理问题康复治疗, 皮肤相关疾病, 癌症手术后 / 化疗后康复协助. 请事先来电预约针灸服务!*** 若需中文预约服务, 请拨打 425-449-8851转109分机 ***英文預約服務, 則請撥打425-449-8851轉3分機( Schedule Your Acupuncture Appointment in English, Please Call 425-449-8851 option 3 )
– Appointment –
To schedule an appointment with Christian Therapists for Mental Health Counseling services, NeurOptimal – Neurofeedback Training and Acupuncture Treatment, or to obtain additional information about Mental Health Counseling services, Neurofeedback Training and Acupuncture, please contact Tender Rock Counseling, NeurOptimal – Neurofeedback, Acupuncture Clinic, in Redmond / Bellevue / Factoria / Eastside, WA 98006. ( Non Profit Organization | Counselors with Christian Faith)

To schedule an appointment with Christian Therapists for Mental Health Counseling services and Acupuncture Treatment, or to obtain additional information about Mental Health Counseling services and Acupuncture, please contact Tender Rock Counseling / Acupuncture Clinic, in Bellevue / Factoria / Eastside, WA 98006. ( Non Profit Organization | Counselors with Christian Faith). Acupuncture Appointment, Acupuncture Appointment Bellevue, Acupuncture Appointment Eastside WA, Acupuncture Appointment Factoria WA, Acupuncture Appointment Redmond WA, Acupuncture Appointment Seattle WA, Acupuncture Appointment Bellevue WA.

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